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Wang Ruhe, a Jinshi degree holder, suddenly fell into unconsciousness due to overexertion and lack of proper recuperation. This was caused by deficiency of Yuan Qi (Original Qi) leading to reckless movement of deficient fire, accompanied by phlegm. He was urgently administered with Tongbian (child's urine), after which his mental clarity gradually returned. Subsequently, he was prescribed Ren Shen (Ginseng Radix) and Huang Qi (Astragali Radix) each 5 qian, Xiong (Chuanxiong Rhizome) and Gui (Danggui Radix) each 3 qian, Xuan Shen (Scrophulariae Radix), Chai Hu (Bupleuri Radix), Shan Zhi (Gardeniae Fructus), and Zhi Cao (Prepared Licorice Root) each 1 qian. After ingestion, his condition stabilized slightly. Observing his extreme physical fatigue, he was further treated with Shiquan Dabu Tang (Decoction for Complete Great Tonification) added with Wu Wei Zi (Schisandrae Fructus) and Mai Men Dong (Ophiopogonis Tuber), resulting in recovery. Generally, when an individual has constitutionally weak Yuan Qi, it may be due to improper daily routine, dietary and physical overexertion, or excessive mental labor, leading to spermatorrhea and leukorrhea, spontaneous sweating or night sweats; or internal heat, afternoon fever, tidal fever, or general fever; or dry mouth and thirst, sore throat and cracked tongue; or distension and swelling of the chest and breasts, pain in the hypochondrium; or pain in the head, neck, and elbows, dizziness and blurred vision; or restlessness of the heart-mind, inability to sleep while awake; or dark and scanty urination with pain in the urethra; or dribbling after urination with coldness in the umbilical and abdominal regions and genitals; or emaciation and aversion to cold in the limbs; or rapid nasal breathing; or any other heat symptoms. These are all rootless deficient fires. By taking the aforementioned decoction to consolidate the root, all symptoms will naturally subside. If one mistakenly attacks the wind-heat, it would be an error.

Gao Shucheng, an official at the Guanglu Temple, had constitutionally weak Spleen and Stomach. Due to dietary and physical overexertion, he suffered from abdominal pain and chest fullness. Mistakenly using Da Huang (Rhei Radix et Rhizoma) and other purgatives led to delirium, irritability, headache, panting, sweating, frequent vomiting and diarrhea, and occasional unconsciousness. His pulse was large and disordered. He was treated with Liujunzi Tang (Six Gentlemen Decoction) added with Pao Jiang (Prepared Ginger) for four doses, after which he stabilized. However, he remained fatigued with poor appetite, dry mouth, and fever, with floating and rapid pulses in all six positions. There was a desire to use fire-draining herbs. I said: Intermittent fever indicates deficient fire rather than excess heat; a floating and large pulse indicates Blood deficiency; a void and floating pulse indicates Qi deficiency. This is because Stomach Qi deficiency leads to loss of the Five Zang organs, manifesting as deficiency syndromes. After taking tonics for the Stomach, all symptoms receded.

Xu Keming, a Dayin official, suffered from evening fever, dry mouth, body fatigue, dark and scanty urination, and soreness and pain in both legs due to improper diet. I treated him with Buzhong Yiqi Tang (Decoction for Boosting the Middle and Augmenting the Qi). Being knowledgeable in medicine, he self-prescribed Siwu Tang (Four Substance Decoction) combined with Huang Bo (Phellodendri Cortex) and Zhi Mu (Anemarrhenae Rhizoma). Instead, he developed dizziness, red eyes, tinnitus, dry lips, alternating chills and fever with abundant phlegm, painful hot stools, and dark scanty urination. He then took Siwu Tang combined with Huang Qin (Scutellariae Radix), Lian Zi (Coptidis Rhizoma), and Zhi Shi (Aurantii Fructus), leading to chest and diaphragm fullness, reduced appetite, and profuse sweating like water. He subsequently used Erchen Tang (Two Aged Herbs Decoction) with Huang Qin, Lian Zi, Huang Bo, Zhi Mu, Mai Men Dong, and Wu Wei Zi, resulting in delirious speech and shaking of the hands. The condition worsened with repeated treatments. Seeking my help again, I prescribed Ren Shen and Huang Qi each 5 qian, Gui and Bai Zhu (Atractylodis Macrocephalae Rhizoma) each 3 qian, Yuan Zhi (Polygalae Radix), Fu Shen (Poria with Hostwood), Suan Zao Ren (Ziziphi Spinosae Semen), and Zhi Cao each 1 qian. After taking it, he slept soundly for a long time, and after four doses, he felt somewhat relieved. He was then regulated and tonified with Bazhen Tang (Eight Treasures Decoction) until cured.

The term "Yin deficiency" actually refers to Spleen deficiency. The Spleen is the organ of supreme Yin. When previous symptoms arise from Spleen deficiency, it is because the Spleen derives from the Stomach. Therefore, sweet-warm agents should be used to generate Yuan Qi in the Stomach and eliminate great heat. Why use bitter-cold herbs to injure Spleen Blood? If the aforementioned symptoms indeed belonged to Kidney Meridian Yin deficiency, it would also be because Kidney Yang deficiency fails to generate Yin. The Classics state: Without Yang, Yin cannot be generated; without Yin, Yang cannot transform. It also states: For deficiency, tonify its mother. One should use Buzhong Yiqi Tang and Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) to tonify the mother. It is especially inappropriate to use bitter-cold drugs. People often mistake Spleen deficiency for Kidney deficiency and indiscriminately use Huang Bo and Zhi Mu, thereby injuring the vital Qi of the Stomach and harming many people.

Generally, deficiency of the Three Yin meridians of the foot (Liver, Spleen, Kidney) is often caused by dietary and physical overexertion, leading to the Kidney failing to generate the Liver, and the Liver failing to generate Heart Fire, thereby damaging Spleen Earth and failing to nourish and transform. If one only tonifies Spleen Earth, Lung Metal becomes prosperous and generates Kidney Water, Liver Wood becomes balanced and naturally generates itself.

A certain man, upon exertion, experienced reduced appetite, chest fullness, fever, headache, expectoration, and thirst, with a floating and large pulse. I said: This is a disease of Stomach and Spleen Blood deficiency. The Spleen belongs to Earth and is the organ of supreme Yin that generates Blood, hence it is called Yin deficiency. He did not believe this and took Erchen Tang, Huang Lian (Coptidis Rhizoma), Zhi Shi, and Hou Po (Magnoliae Officinalis Cortex), causing symptoms to worsen. He then took Siwu Tang, Huang Bo, Zhi Mu, and Mai Men Dong, leading to abdominal pain and vomiting, with a flooding and rapid pulse lacking order. I first used Liujunzi Tang added with Pao Jiang, alleviating pain and vomiting. Then, Buzhong Yiqi Tang completely cured him.

Liu Guanqing, a Xiucai degree holder, suffered from improper exertion and irregular diet, leading to limb fatigue, fever, thirst, headache, and aversion to cold. Mistakenly using Renshen Baidu San (Ginseng Detoxifying Powder) caused phlegm-panting, unconsciousness, flailing of arms and legs, and macules on the chest resembling mosquito bites. I treated him with Buzhong Yiqi Tang added with Sheng Jiang (Fresh Ginger), Rou Gui (Cinnamomi Cortex), Mai Men Dong, and Wu Wei Zi, curing him through tonification.

Huang Wuxuan, suffering from fever and aversion to cold due to dietary and physical overexertion, had his condition worsened by someone using exterior-releasing medicines. After two doses, he became unconscious with black macules on his chest. His pulse was flooding and rapid but forceless. I intended to use Buzhong Yiqi Tang, but he refused and died.

A scholar, accustomed to hard work, suffered from hematochezia (blood in stool) of either bright red or dark color due to irregular diet. Half a year later, he alternated between hematochezia and night sweats, or chills and fever. Hemostatic and antiperspirant drugs were ineffective. All six pulses were floating and large, while the Heart and Spleen pulses were choppy. This was due to excessive worry injuring the Heart and Spleen, failing to control blood and return it to its source. Blood is sweat, and sweat is blood. The red and dark colors of blood and sweat, along with hematochezia and night sweats, reflect the varying degrees of ascent and descent of Fire. Chills and fever indicate dual deficiency of Qi and Blood. Therefore, during the morning, Guipi Tang (Restore the Spleen Decoction) added with Mai Men Dong and Wu Wei Zi was used to tonify Heart and Spleen Blood and collect dissipating fluids.

On the first day of spring in the Gui Mao year, at a gathering at the Gu family residence in Xiabao, a scholar named Xu Meicun said: My relative, Master Ma, suffered from fever, irritability, and thirst, with occasional headaches. Yesterday, after taking dispersing medicines, his asthma and urgency worsened, accompanied by abdominal pain and profuse sweating like water, and delirium day and night. I suspected this was due to injury of Yuan Qi from exertion and mistaken sweating, and that his abdomen would prefer pressure. Xu went to inquire, and it was confirmed. Thus, Shiquan Dabu Tang added with Fu Zi (Aconiti Lateralis Radix Praeparata) 1 qian was given. After taking it, he slept soundly and could not be awakened, causing panic in the family. Upon waking, all symptoms instantly receded, and after two more doses, he recovered.

For ordinary people, improper diet, exertion, and daily routine leading to all kinds of fire symptoms belong to true cold inside and false heat outside. Therefore, the abdomen prefers warmth, and the mouth fears cold substances. This indicates insufficiency in both form/Qi and pathology/Qi. The method should be purely tonifying Yuan Qi.

A scholar suffered from tightness and dryness of both eyes in the late afternoon, unable to see clearly. This was sinking of Yuan Qi. He was treated with Buzhong Yiqi Tang with doubled amounts of Ren Shen and Huang Qi, recovering after several doses.

A man suffered from the same symptoms as above. After taking Huang Bo and Zhi Mu, his eye disease worsened, and he additionally suffered from hematochezia. This was because Spleen Qi deficiency failed to control blood, and Liver Qi deficiency failed to store blood. He was treated with Buzhong Yiqi Tang and Liuwei Dihuang Wan to tonify Liver and Spleen to generate Kidney Water, and all symptoms gradually improved.

A man suffered from chills and fever due to dietary and physical overexertion, with numbness in the right hand. Mistakenly diagnosed as Ding Du (carbuncle/toxic boil), he applied and ingested cold-cooling detoxifying agents, leading to swelling, heaviness, sallow complexion, limb fatigue, and floating, large pulses that vanished upon deep pressure. This was deficiency of Spleen and Stomach Qi. Inquiry revealed he was a silver refiner who immersed hot hands in water for melting silver, allowing cold to congeal in the collaterals, and previous medicines further injured Yuan Qi. He was cured with Buzhong Yiqi Tang and warm-tonifying medicinal baths for his hands.

A scholar accidentally nicked the nail of his big toe while trimming, with no bleeding or pain, and normal appearance. Later, due to dietary and physical overexertion, his foot became heavy, slightly swollen, and painful. Sleep patterns varied, but foot symptoms persisted. Mistakenly taking detoxifying agents caused chills, fever, swelling, and pain. Since the Spleen meridian originates at the big toe, this was sinking of weak Spleen Qi. He was cured with Shiquan Dabu Tang.

I personally enjoy sitting and reading books. Prolonged sitting leads to fatigue, requiring me to take Buzhong Yiqi Tang added with Mai Men Dong, Wu Wei Zi, and a small amount of wine-fried black Huang Bo to feel mentally clear. Otherwise, I suffer from insomnia at night, sourness and heat in the medial aspect of the feet. If insomnia persists, the medial calves become similarly affected, with a sensation of tendon contraction, causing frequent shifting of legs and restlessness until extreme exhaustion induces sleep. This is injury of Yuan Qi from exertion, with deficient fire pouring downward due to void.

In the Ding You year, at age 51, I felt a blockage-like sensation in the gum crevices, causing distension and discomfort, sometimes with oral ulcers, worsening in the afternoon. Long sleep or taking the aforementioned medicines provided relief. By the Xin Chou year, at age 55, daytime gum distension was relieved by one dose of Buzhong Yiqi Tang, allowing nighttime sleep. In the Ren Yin year, amidst family mourning, although I took the previous formula during the day, nighttime gum distension persisted. Only before noon did teeth and limbs feel relatively healthy; they distended again in the afternoon. Observing this, it is evident that Blood and Qi decline daily, necessitating different treatment methods.